Tag Archives: Mohs surgery

Skin Cancer Treatment – Fluorouracil Day 2

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Day two on Fluorouracil has been pretty uneventful. Last night my face tingled a lot and it felt like I had a mild sunburn (oh the irony). I sleep on my side so my pillow case kept sticking to my cheeks every time I went to turn over. I hear it is even more fun when your face begins to bleed and fester. Plastic covers under the pillowcases anyone?

This morning my face was still pink but the day was mostly uneventful with the exception of the fact I felt slightly irritated. More than likely not a side effect of the drug at this early juncture but feeling a little trapped by the thought of being a slave to this chemical for the next three weeks and not certain how intensely my skin is going to react.

There are a few tiny red spots that are already beginning to pop out on my forehead but nothing worth taking a photo of yet. So I decided to post some photos from my last nature walk this past Sunday instead.

It was my last chance to get in a good walk before starting the Fluorouracil. The medication makes you extra sensitive to UV rays. I have seen the photos of people who used the drug and made the mistake of going out in the sun. Even with sunscreen and short exposure times, their faces became terribly inflamed. Thus I have decided to become a vampire and go on walks after the sun goes down. It makes life more exciting that way :-).

So for now, here are a few iPhone photos I shot using the Tintype app by Hipstamatic. They were shot along the Barge Access Canal across from the Port of Sacramento.

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Skin Cancer Treatment – Fluorouracil Day 1

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Today was the first day of my topical chemotherapy treatment for skin cancer with 5% Fluorouacil. For those of you who have not followed my blog up to this point, I have been through two different surgeries to remove Basal Cell Carcinomas in the past few months. The first was a more advanced lesion on my back. It was removed by way of Curettage and Electrodessication. The second one was on my face near my eye on the Medial Canthus and was removed with Mohs surgery. I have also had close to two-dozen Actinic Karatoses removed from my face, hands, legs, arms and chest through Cryosurgery.

My Dermatologist was a bit concerned by the amount of pre-cancerous lesions that were apparent on my sun damaged face. He prescribed 5% Fluorouracil to stop the growth of cells in both the pre-cancerous lesions and any Basal Cell Carcinomas that may be lurking under the surface.

Fluouracil is an Antimetabolite originally used as an internal chemotherapy to treat a variety of cancers. On the cellular level, Antimetabolites interfere with both DNA and RNA synthesis thus the cancerous cells die off because they can no longer replicate.

If you do a Google search of Fluorouracil, or more specifically “Efudex” treatment, you will find a lot of scary looking photos and some videos from different stages of treatment. Not everyone reacts the same way to this drug. Some individual experiences are more dramatic than others. It all depends on how many lesions you have on or beneath the surface on the skin being treated. Some people are only prescribed treatment for specific or small areas on their bodies so the overall dosage is minimal. However, some people like myself have been prescribed treatment at maximum dosage to cover a larger area, in my case the whole face.

I have decided to document my treatment with photos and updates on my blog and will file these types of posts under the “Skin Cancer” category for those who are interested in following along. I also feel it is important for others who may have to go through this same treatment in the future to know the reality of a variety of people who have used it. I know it helped me immensely to research and read other skin cancer patient’s blogs prior to my treatment.

So here is day one photo of my lovely face sans makeup (just for you) immediately prior to applying my first dose this morning. Note the smile on my face (we shall see how long that lasts).

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I will be applying Fluorouracil to my face twice daily for three weeks straight. There are many possible side effects including: Skin irritation, burning, redness, dryness, pain, swelling, tenderness, changes in skin color, eye irritation (e.g., stinging, watering), trouble sleeping, irritability, temporary hair loss, or abnormal taste in the mouth.

These are the more uncommon but serious side effects: stomach/abdominal pain, bloody diarrhea, vomiting, signs of infection (e.g., fever, chills, persistent sore throat), easy bruising/bleeding, mouth sores, rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Yes I know this now sounds like one of those television commercials that I hate so much and question why anyone would use one of those drugs with the risk of all those side effects.

But the benefits definitely outweigh the risks when it comes to skin cancer. Fortunately, the more serious side effects happen to a small percentage of users.

I will be applying the second dosage in about half an hour. Most people do not experience much reaction until after seven days of use. I happen to be blessed (or cursed) with very sensitive skin and my face is already beginning to turn pink and it feels as if I have a slight sunburn. I get the feeling I am going to end up being one of the “prettier” Efudex patients before too long.

And away we go!


Of Frozen Peas and Prize Fights

Frozen peas are my friend.

Frozen peas are my friend.

Today I look like a prize-fighter. Fortunately my opponent looks far worse than I do at this moment in time. Yesterday’s surgeries went well. After a six-hour day of needles, scalpels, bandages, blood and stitches, I can now say I am cancer free. So this week I am focused on healing. Bags of frozen peas have become my best friend for reducing the swelling and controlling the bruising. Once I am fully healed I will move on to the topical chemo in a few months to eradicate any hidden gremlins that might be lurking in the shadows.

The scene of my Mohs surgery.

The scene of my Mohs surgery.

Thank you all for the kind words, prayers and positive thoughts you’ve sent me while I travel down this inconvenient but hopefully short side road along this occasionally convoluted journey we call “life.”

The reconstruction surgeon, Dr. J., who made me all pretty again.

The reconstruction surgeon, Dr. J., who made me all pretty again.


On the Eve of Mohs

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Tomorrow morning I have the Mohs surgery to remove the rest of the tumor on my eyelid (Medial Canthus). The length of the surgery is dependent on how wide and deep the roots of the cancer have grown. The surgeon will take a slice, bandage me up and send me to a waiting area while he freezes the sample and looks at the cells under a microscope. If the margins are not clear he will take another slice and repeat. This process will continue until he views clear margins. They told me it typically takes from three to five hours with most undergoing three passes of the scalpel, some much more.

Once the margins are clear he will inject a longer-lasting anesthetic, bandage me up again and send me on my way to the Oculoplastics surgeon for reconstruction and closure of the surgery site.

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After the surgeries I will have to ice my eye/face 20 minutes on/off for the first three days followed by warm compresses until the stitches are removed, keep the area clean, and put artificial tears in my eyes four times a day. I will have to sleep in a recliner to keep my head elevated and cannot lift much of anything, am not supposed to bend over nor do any exercise. Basically I am supposed to rest and let it heal.

My biggest concern is of course in which direction he will have to cut to follow the cancer. I am hoping it is away from my eye. My second concern is the amount of time my eye will remain swollen and how soon I will be able to wear my glasses. I am pretty blind without them.

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The surgery site on my back is healing well with minimal pain although I have been experiencing daily headaches. Yesterday I was able to go on an easy hike around Sly Park lake for a bit of pre-surgery nature therapy. It felt good to get out in nature but I was not feeling well by the time I got back to the picnic area.

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Tonight I am understandably a bundle of nerves. I am trying to keep myself grounded and positive but I don’t like the fact there are so many unknowns right now. Of course it will all become clear as the surgeon begins his task and I will walk away at the end of the day knowing without a doubt that all the cancer has been removed.

I will update you all as soon as I get to the other side :-).

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The Waiting Game

"Upside Down" - ©Tracy J Thomas, 2014. All rights reserved.

“Upside Down” – ©Tracy J Thomas, 2014. All rights reserved.

The past few weeks have been spent focused on design projects for clients while finding ways to keep my stress levels under control. Burying myself in “busy” is a great way to forget about the cancer but it doesn’t necessarily bode well for subconscious stress management. We have been having quite the heat spell here in California so I have not been spending as much Zen time out in the garden with my camera. Instead I have been starting my days off by making my way to the air-conditioned gym to pedal, lift, and sweat away all those ugly stress bugs.

"Cradling the Moon" - ©Tracy J Thomas, 2014. All rights reserved.

“Cradling the Moon” – ©Tracy J Thomas, 2014. All rights reserved.

The surgery to remove the cancer on my back is now scheduled for August 27th. The back surgery should be relatively straight forward with minimal recovery time. A lot will depend on the pathology report a few days following the excision. If the margins are not clear, then I will need to go back in for more. If they are clear then I will have 10 days to recover before the Mohs surgery on my face.

I am the most nervous about the surgery on my face. Most of that comes from all the unknowns that are tied in with this spot. They won’t know until they begin to cut away, freeze the tissue and look under the microscope how much they will need to remove that day. It could be anywhere from a few passes to an all day affair. It all depends on how far the cancer has spread beneath the surface. Once the surgeon gets clear margins I will then need to have reconstructive surgery with the Oculoplastics surgeon that same day. Again, how much reconstruction I will need is an unknown until the cancer is removed.

Hibiscus flower - ©Tracy J Thomas, 2014. All rights reserved.

Hibiscus flower – ©Tracy J Thomas, 2014. All rights reserved.

On Tuesday of this week the U.S. Surgeon General for the first time ever issued a call to action to prevent this disease. This warning is long overdue. Hopefully it will have a strong impact on how people think about UV exposure and the real threat it has on their health. I know it took my own diagnosis to shake up my world and clarify for me the real dangers of tanning, whether it be from the sun or in a tanning bed.

Please wear your sunscreen and those big, floppy, oh-so-sexy hats. Protect yourselves and the ones you love. Pale is definitely the new sexy.